The ShiftShapers Podcast

Cybercriminals don’t need to “hack” our systems when they can trick someone into handing over access, and AI is making those tricks more realistic and scalable. We talk with Daniel Metcalfe of Cyberfin about where benefits advisors are most exposed and the layered, practical steps that reduce breach risk while still letting teams use AI responsibly.  • why employee and employer data is “gold” to a...

The fastest way to waste a benefits budget is to ignore the beliefs running the workplace. If employees aren’t engaging with expensive benefits plans, the problem may not be the coverage or the vendor list. It may be the everyday mindset that shapes trust, motivation, and how safe people feel speaking up. We sit down with Lizzie Benton, founder of Libertymind, to unpack what “mindset” really means...

We talk with Jared Pierce about why many provider networks run on outdated contracts and why that breaks trust for providers, members, and plan sponsors. We dig into how Unity builds a primary, provider-aligned network for self-funded plans that protects access while still driving real savings.  • Jared’s early start building PPO networks at 17 and how it shaped his view of the system  • Why legac...

We bring compliance specialist Carol Taylor back to unpack why employers keep getting blindsided by benefit plan obligations like RXDC reporting, PBM disclosures, and fiduciary duties under ERISA. We map the real-world risks, the paperwork traps that cause rejected filings, and the simple audit habits that keep penalties from stacking up.  • RXDC reporting basics and why it exists  • why employers...

We talk with Mark Gaunya about why employer health insurance often feels like a casino where the house wins and how employers can flip the odds with transparency, ownership, and smarter plan design.  We break down how captive risk sharing works, what it takes to implement, and the real financial and employee-experience wins that come from getting off the less bad renewal hamster wheel.  • Why the...

We challenge the old wellness playbook and show how coaching, claims integration, and clinical guardrails turn behavior change into measurable cost control. GLP-1s, chronic condition priorities, and realistic timelines come together in a system that bends trajectories instead of chasing fads. • why awareness and incentives fail without habit formation • building coaching into chronic care to shift...

Medicare is full of fine print, fast-changing rules, and enough junk mail to fill a suitcase. So what actually separates the agents who barely survive from the ones who become the trusted name in their community? We sit down with Paige Phillips, founder of the Paige Phillips Insurance Agency and author of Medicare Playbook for Agents, to get practical about what works when the stakes are someone’s...

Healthcare stays expensive because the system hides prices and quality from the people paying for care, especially employers. We talk with Katie Talento about how CAA 2026 transparency and Department of Labor fiduciary rules could expose PBM practices, reshape contracting, and give plan sponsors real leverage if enforcement follows. • Why invisible prices and invisible quality break the healthcare...

Surprise billing for patients is largely gone, so why are so many self-funded employer health plans still getting hammered by out-of-network costs? We sit down with Scott Bennett, Chief Provider Relations Officer at the PHIA Group, to unpack what the No Surprises Act is doing in the real world and why federal arbitration is starting to look less like a safety valve and more like a payment engine....

Employers keep paying for the symptoms of obesity, diabetes, and metabolic syndrome while the root causes go untouched. We unpack why many wellness models fail, how insulin resistance hides for years, and what chronic disease reversal can look like when a physician-led metabolic health team measures the right signals and tapers meds safely.  • metabolic syndrome as a dominant driver of employer he...

We explore how employers can manage healthcare like any other cost by shifting from insurer-built, passive plans to employer-built, actively managed designs. Carl Schuessler, Jr. shares candid tactics on data, precision testing, and honest change management that help advisors become true risk partners. • defining a health plan mission that aligns to EBITDA and predictability • focusing on data hot...

We dig into who truly makes claim decisions in self-funded plans and why that matters when ethics and compliance collide. Adam Russo shares how fiduciary prudence, transparent compensation, and NSA arbitration are reshaping risk, trust, and costs. • plan sponsors as final decision makers on claims • plan documents lagging laws and mandates • compliance versus ethics as distinct obligations • trans...

We dig into why growth stalls when roles blur and the founder stays the bottleneck. Forrest Durer shows how clear seats, weekly scorecards, and steady leadership cadence create accountability and make scaling calm and repeatable. • common founder-led bottlenecks and warning signs • seats defined by 5–7 responsibilities not titles • building a simple pyramid with an integrator or COO • activity-bas...

We revisit how employers can control healthcare spend while expanding employee choice through ICRAs, with Chad Schneider of Thatch sharing what works, what breaks, and what’s next. We dig into change management, decision tools, dynamic contributions, and the broker’s evolving role. • Why ICRAs surged after 2020 and boomed in 2024 • Carrier expansion and a stronger individual market • The real barr...

We revisit how PPOs got built on discounts and show why total value beats sticker price. Scott Smith joins us to explain nationally curated high-performance networks that rank providers on effectiveness, appropriateness, and cost, and how that changes renewals, member experience, and fiduciary risk. • why traditional PPO discounts miss total cost of care • how consolidation and narrow networks inc...

We explore how reducing variation in cost, outcomes, and experience creates real value, and why deep provider metrics and real-time member support outperform box-checking credentialing. Kate Grohal shares a playbook for aligning incentives without repeating the mistakes that soured HMOs. • defining quality as reducing variation across cost, outcomes, experience • Kate’s path from patient escort to...

We revisit the rising problem of the “functionally uninsured” and ask how to restore real access for employees who delay care because of confusion and cost. Paymedix CEO Tom Policelli shares how a super EOB, upfront provider payment, and 0% financing change behavior and bend trend. • confusion outranking cost as the top barrier to care • hospitals pushing prepayment and the access wall it creates...

Pharmacy benefits shouldn’t feel like a black box. We sit down with Susan Thomas, Chief Commercial Officer at Lucy Rx, to unpack why drug costs keep rising and what it takes to build a benefit that serves patients and plans—not middlemen. Susan started as an oncology nurse and moved into PBM leadership, and that dual lens shows up in everything we cover: from the real-world stress of waiting days...

What if benefits work leaped from horse‑and‑buggy speed to highway pace? We sit down with Julian Lago, co‑founder and CEO of BenePower, to explore how AI is already compressing days of quoting, enrollment, and service into minutes—and what that means for brokers, HR leaders, and members who need clear answers right now. We dig into the practical side of agentic AI and retrieval‑augmented generatio...

Change can energize or paralyze—so we chose energize. We sat down with Eric Silverman, founder of Voluntary Disruption and a four-time guest, to unpack what’s actually moving the needle in enhanced benefits today. The surprise? Products haven’t radically shifted, but execution has. Simple, high-interest options like pet insurance, ID protection, legal plans, and life paired with long-term care con...

What if the clinic your team actually uses is the one parked outside the office? We sit down with Chris Yarn, CEO of Walk On Clinic, to unpack why on-site and mobile primary care crush near-site options on utilization, trust, and measurable savings—often with fewer clinic days. The story begins with a simple truth: convenience wins. When clinicians are visible and familiar, employees engage more,...

We explore what executive coaching really is, how it helps leaders make better decisions and show up with presence, and why advisors can use it to grow their practice and help clients cut costs and claims. We share signals that coaching is needed, how to introduce it without awkwardness, and how to build strong referral partnerships. • Clear definition of executive coaching and who benefits • Comm...

Healthcare costs keep climbing while employees want plans that actually fit their doctors, budgets, and lives. We tackle that tension head-on with Chad Schneider, head of broker channel at Thatch, and unpack how ICHRAs—individual coverage HRAs—let employers lock in predictable budgets while giving every employee real choice on the individual market. We start by demystifying ICHRAs and why 2024 bec...

Costs are spiking, access is shrinking, and members are stuck on hold while scans get delayed—yet the fix might be hiding in plain sight. We sit down with Dr. Cristin Dickerson, CEO of Green Imaging, to unpack how independent imaging, transparent bundles, and human-led AI can lower trend, reduce friction, and actually make benefits plans feel usable. From private equity acquisitions that quietly t...

Leadership bottlenecks can silently strangle even the most promising companies. When decisions, initiatives, and progress all funnel through one person—typically the founder or CEO—growth becomes impossible. Charlie Rhea knows this pattern all too well. As an implementer of the Entrepreneurial Operating System (EOS), Charlie has witnessed the remarkable transformation that occurs when leadership t...